Dr. Andrew Siegel, a urologist in Hackensack, New Jersey, discusses pelvic floor muscle exercises.
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A Kegel exercise, named after Dr. Arnold Kegel, consists of contracting and relaxing the muscles that form part of the pelvic floor (which are now sometimes colloquially referred to as the “Kegel muscles”).
The aim of Kegel exercises is to improve muscle tone by strengthening the pubococcygeus muscles of the pelvic floor. Kegel is a popular prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and vaginal childbirth. Kegel exercises are said to be good for treating vaginal prolapse and preventing uterine prolapse in women and for treating prostate pain and swelling resulting from benign prostatic hyperplasia (BPH) and prostatitis in men. Kegel exercises may be beneficial in treating urinary incontinence in both men and women.Kegel exercises may also increase sexual gratification and aid in reducing premature ejaculation.
Benefits for women
Factors such as pregnancy, childbirth, aging, being overweight, and abdominal surgery such as cesarean section, often result in the weakening of the pelvic muscles. This can be assessed by either digital examination of vaginal pressure or using a Kegel perineometer. Kegel exercises are useful in regaining pelvic floor muscle strength in such cases.
The consequences of weakened pelvic floor muscles may include urinary or bowel incontinence, which may be helped by therapeutic strengthening of these muscles. A meta-analysis of randomized controlled trials by the Cochrane Collaboration concluded that “PFMT [Pelvic floor muscle training] be included in first-line conservative management programs for women with stress, urge, or mixed, urinary incontinence…The treatment effect might be greater in middle aged women (in their 40’s and 50’s) with stress urinary incontinence alone…”.
The exercises are also often used to help prevent prolapse of pelvic organs. A meta-analysis of randomized controlled trials by the Cochrane Collaboration concluded that “there is some encouragement from a feasibility study that pelvic floor muscle training, delivered by a physiotherapist to symptomatic women in an outpatient setting, may reduce severity of prolapse”.
Benefits for men
Though most commonly used by women, men can also use Kegel exercises. Kegel exercises are employed to strengthen the pubococcygeal muscle and other muscles of the pelvic diaphragm. Kegels can help men achieve stronger erections and gain greater control over ejaculation. The objective of this may be similar to that of the exercise in women with weakened pelvic floor: to increase bladder and bowel control and sexual function.
Regarding postprostatectomy urinary incontinence, a meta-analysis of randomized controlled trials by the Cochrane Collaboration found “conflicting information about the benefit of pelvic floor muscle training for either prevention or treatment of urine leakage”.
Kegel workouts can provide men with stronger erections. Research published in 2005 issue of BJU International, have shown that pelvic floor exercises could help restore erectile function in men with erectile dysfunction. There are said to be significant benefits for the problem of premature ejaculation from having more muscular control of the pelvis. It is also possible that strengthening the pelvic floor may allow some men to achieve a form of orgasm without allowing ejaculation, and thereby perhaps reach multiple “climaxes” during sexual activity. In men, this exercise lifts up the testicles, also strengthening the cremaster muscle, as well as the anal sphincter muscles, as the anus is the main area contracted when a Kegel is done. This is because the pubococcygeus muscle begins around the anus and runs up to the urinary sphincter.
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